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Compartment Syndrome (part I)

A compartment is defined as a closed space of nerves, muscle tissue and blood vessels. This space is surrounded by fascia (thick layer of tissue) that doesn’t stretch. When the pressure inside the compartment increases from any cause and if the pressure increases substantially, this may lead to the compression of the nerves, blood vessels and muscles inside the compartment. The result may be impaired blood flow and reduced oxygenation that may result in muscle and nerve damage. Compartment syndrome most commonly involves the forearm and lower leg although it can occur in other places. Compartment syndrome can be acute, subacute or chronic (see below).

Causes:

An injury that leads to an increase in the pressure inside the compartment may cause compartment syndrome, these may include:

  • Burns such as third degree burns.
  • Car accidents or crush injuries.
  • Hemorrhage (bleeding into the compartment).
  • Tight bandages or casts.
  • Intravenous drug injection.
  • Surgery.

Signs and symptoms: may include

  • Pain: it is usually severe pain and out of proportion with the injury. The pain doesn’t respond to pain medication and is increased by stretching the muscle group within the compartment.
  • Alteration or decrease sensation of the skin.
  • Paleness of the skin.
  • Weakness and in later stages paralysis of the limb may occur if not treated.
  • Capillary refill time (the rate at which blood refills empty capillaries) of the digits is prolonged.
  • Congestion of the digits.

Diagnosis:

  • Clinical diagnosis based on the signs and symptoms.
  • Measuring the pressure inside the compartment. This may be done by inserting a needle attached to a pressure meter into the compartment.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.